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As land hassles stem the flow of NRI investment in Punjab, the Government takes steps to ease the legal woes of expatriates.

 

 
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The rampant misuse of the Dalit Act in Uttar Pradesh has a larger malaise behind it, writes India Today's Subhash Mishra
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The Conclave concludes on a high note. Al Gore, Stanley Fischer and other world leaders listen and are heard. Catch up on the highlights.
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 CURRENT ISSUE APRIL 28, 2003  

HEALTH: SARS EPIDEMIC

The Dread Alert

The SARS virus arrives in India but he case remains shrouded in confusion and contradictions.

By Supriya Bezbaruah With Nidhi Taparia
 

The dreaded SARS virus has finally arrived in India. Or has it? In typical Indian style, the case of India's first SARS victim has been shrouded in confusion and contradictions from day one.

KEEPING A WATCH: Hospitals are gearing up for SARS cases

Till April 16, Prashil Varde, 32, was merely a marine engineer suffering from a mild fever while in Goa. Varde had sailed to Hong Kong in March and from there went to Singapore with his wife before flying back to Mumbai and proceeding to Goa. It was in Goa that Varde developed a mild fever of 100 degree F. Had he not visited a SARS-affected country recently, it was hardly a reason to be alarmed about. So Varde went to a private practitioner, who saw his itinerary and immediately referred him to the Goa Medical College on April 10. The WHO definition of a probable SARS case includes high fever, coughing or breathing difficulty and pneumonia. Anyone visiting a SARS-affected country or having prolonged close contact with a SARS victim is vulnerable. But Varde's fever had subsided and his chest X-ray appeared normal. It seemed he was in the clear. He wasn't.

On April 17, at two hurriedly convened press conferences-one addressed by Director-General of Health Services S.K. Aggarwal in Delhi and the other by Goa Chief Minister Manohar Parrikar in Panaji-it was announced that the SARS virus had been found in Varde's blood, sputum and urine samples tested at Pune's National Institute of Virology (NIV). SARS had arrived in India.

Later in the evening, Union Health Minister Sushma Swaraj confirmed the alarming development. "We are happy that the reagents we are using to test for the SARS virus are effective and that our surveillance system for SARS is working effectively," she said. She added that a team from Delhi's National Institute of Communicable Diseases (NICD) had been sent to Goa. Varde, who had been discharged from hospital on April 12, was placed in an isolation ward to ensure that the infective stages of the disease, normally 2-10 days, were truly over.

SARS-or Severe Acute Respiratory Disease-first came to light in February this year in China, Vietnam and Hong Kong. Caused by a new, deadly form of the virus family that causes common cold, SARS has spread rapidly in this jet age, triggering possibly the shrillest global health alert in recent times. Till date, some 3,400 people have been infected by the virus worldwide. About 165 have died. Eleven disease control centres in nine countries have worked overtime to study the causes of SARS. It has now been confirmed by who that a corona virus, previously unknown to man, is the cause. The presence of another new virus, which belongs to the family which causes chicken pox and mumps, has also been found in some SARS patients.

PREVENTIVE STEPS: Officials don masks at Delhi airport

Barely hours after Swaraj announced the first SARS case in India, Parrikar and his Health Minister Suresh Amonkar met journalists again to say that the case may be a false alarm and that there had been a "mismatch" between clinical and lab findings. The samples would be sent, they said, for a second opinion to NICD.

Why the confusion? Apparently, Varde suffered only mild symptoms. His wife and father, who were in close contact with him, show no signs of illness. Neither do any of the medical staff who had nursed Varde at Goa Medical College, raising doubts about the accuracy of the tests conducted at NIV. NIV Director A.C. Mishra, however, stands by the results of his institute. "SARS covers a wide spectrum," he says. "Varde's is a mild case which showed up only in fever. But he definitely has been infected by SARS."

Indeed, there are reports of SARS patients with mild symptoms. Neither is the polymerase chain reaction technique used by NIV for the tests completely fool-proof. False positives are possible. Reports from across the world reveal that the disease varies widely. Viruses which have RNA as their genetic material mutate frequently, and it is possible that the SARS virus is still changing.

Considering this, Parrikar has good reason to hope that Varde's case is a false alarm. Goa depends heavily on tourism, and as the South-east Asian experience has shown, SARS is the death knell for the industry. Domestically too it would spell bad news for a tottering tourism industry. Subhas Goyal, chairman, STIC Group of Industries, warns against unnecessary panic. "This is an isolated case. Canada has SARS but no one has stopped going to Canada. More than 20 countries across the world have SARS cases. Why should people stop coming to India?" he asks.

To be fair, the administration is taking all precautions to keep the virus at bay. Incoming passengers are being screened and some labs at NICD have been upgraded. However, according to Sanjay Malik, secretary-general, Indian Medical Association, more awareness of the disease is essential, especially among private practitioners. "Almost three-fourths of the patients in India go to private practitioners and it is essential for them to be involved with the Government," he says.

This may or may not be the beginning of a SARS epidemic in India. But India is no stranger to epidemics. This won't be the first, and it won't be the last.

 
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